Cardiovascular and Cortisol Reactions to Acute Psychological Stress Under Conditions of High Versus Low Social Evaluative Threat: Associations With the Type D Personality Construct

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Objective: Social evaluative threat is an important factor in the cardiovascular response to mental stress. This study examined whether Type D personality, characterized by social inhibition and negative affectivity, is associated with an adverse cardiovascular response to social evaluative threat, thereby contributing to increased risk of cardiovascular disease. We compared physiological stress reactions of Type D and non-Type D individuals in settings varying in social evaluation characteristics.
Methods: 2300 students were screened for Type D personality, and 130 selected for a non-social stress exposure condition (31 Type D, 30 non-Type D: 52% female) or a condition high in social evaluative threat (35 Type D, 34 non-Type D: 55% female). Systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR) and salivary cortisol were measured at rest and in response to stress.
Results: Social evaluative threat resulted in higher cardiovascular responses than the non-social challenge (SBP, p =.001, η2 = .092; DBP, p = .006, η2 = .058; HR, p = .006, η2 = .059). The greatest cardiovascular stress reactions were exhibited by Type D participants in the high social evaluation condition; reflected in significant group x condition interactions for SBP, F(1,126) =7.29, p =.008, η2 =.055, DBP, F(1,126) =5.23, p =.024, η2 =.040, and HR, F(1,126) =5.04, p =.027, η2 =.038, reactivity. Only Type Ds in the social condition mounted a positive cortisol response, F(1,33) =5.07, p =.031, η2 =.133.
Conclusions: It would appear Type D individuals show different stress reactions depending upon the social evaluative nature of the stress exposure, with this dysregulation of the stress response potentially increasing cardiovascular disease risk.


Original languageEnglish
Pages (from-to)599-608
JournalPsychosomatic Medicine
Issue number5
Publication statusPublished - 1 Jun 2015


  • Type D Personality, social evaluation, Cardiovascular reactivity, cortisol reactivity, Psychological stress